P-OT017. Neutrophil-to-lymphocyte ratio, monocyte-to- lymphocyte ratio, and platelet-tolymphocyte ratio biomarkers in severe hemorrhagic stroke patients: Which ratio to choose as a mortality predictor?

Abstract

Introduction . Several biomarkers are now being developed to predict the prognosis of stroke. Ratios of the white blood’s components are widely studied as short-term and long-term prognostic factors in patients with intensive care. Stroke, particularly severe hemorrhagic stroke, is a condition that needs intensive care that has the potential to worsen anytime in its acute period and eventually leads to death. Here, we studied the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) on- admission as potential predictors of in-hospital mortality in severe hemorrhagic stroke patients. Methods . It is a retrospective observational study in severe hemorrhagic stroke with conventional treatment. We reviewed the medical records to obtain clinical and laboratory data and divided the patients into survivors vs non-survivors. The laboratory data were searched for white blood cell (WBC) count, neutrophil count, lymphocyte count, monocyte count, and platelet count. The NLR, MLR, and PLR were then manually estimated. Results . Of the 30 eligible patients, 25 patients were survivors and 5 patients were non- survivors. In the laboratory examinations, the neutrophil, lymphocyte, and monocyte counts showed a significant difference between survivors and non-survivors. Furthermore, we also found that NLR and MLR were two ratios that had significant difference statistically. Also, if we used the NLR cut-off point of 5 to separate high and low NLR, we found that NLR on- admission is associated with in-hospital mortality. Conclusion . NLR and MLR on-admission were significantly different between survivors and non-survivors of severe hemorrhagic patients that were treated conventionally. Also, NLR on- admission > 5 could be associated with in-hospital mortality.